Silent myocardial ischemia in coronary artery disease patients under aspirin therapy presenting with upper gastrointestinal hemorrhage

Chien Chih Chen, Chee Fah Chong, Cheng Deng Kuo, Zong-Lun Wang

研究成果: 雜誌貢獻文章同行評審

4 引文 斯高帕斯(Scopus)

摘要

Aim: To identify the risk factors for myocardial ischemia in patients undergoing aspirin therapy for coronary artery disease (CAD) presenting with upper gastrointestinal hemorrhage and to ascertain the impacts on mortality and length of hospital stay. Methods: Adults with CAD under aspirin therapy (100 mg once daily) presenting to the emergency department with upper gastrointestinal hemorrhage were retrospectively recruited and divided into group A (ischemia) and group B (non-ischemia). Charts were reviewed for various demographic, laboratory and outcome data. Electrocardiograms were interpreted blindly by a senior cardiologist. Results: A total of 152 patients, 72.4% men and 27.6% women, were analyzed. Of these, 31 patients had ischemia and were placed in group A and 121 patients did not have ischemia and were in group B. Independent multivariate predictors of myocardial ischemia were history of triple vessel disease (odds ratio [OR], 9.24; 95% confidence interval [CI], 2.00-42.72), lower diastolic blood pressure (OR, 1.09; 95% CI, 1.02-1.16), lower hematocrit (OR, 1.41; 95% CI, 1.16-1.70), and higher blood urea nitrogen (OR, 0.94; 95% CI, 0.89-0.98). Patients with myocardial ischemia had significantly longer hospital length of stay (8.7 ± 4.0 days vs 5.4 ± 1.7 days; P <0.001) and higher in-hospital mortality (16.1% vs 2.5%; P <0.01) than did those without myocardial ischemia. Conclusion: Myocardial ischemia is a relatively common complication in CAD patients under aspirin therapy presenting with upper gastrointestinal hemorrhage. A history of CAD with triple vessel disease, higher blood urea nitrogen, lower diastolic blood pressure and lower hematocrit may help identify patients who are at increased risk of myocardial ischemia, which tends to be associated with higher in-hospital mortality and increased length of hospital stay.
原文英語
頁(從 - 到)13-17
頁數5
期刊Journal of Gastroenterology and Hepatology (Australia)
22
發行號1
DOIs
出版狀態已發佈 - 2007

ASJC Scopus subject areas

  • 消化內科
  • 肝病

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